Editor's Note

Be Prepared. Be Involved.

The trends impacting HME never stop and neither should you.

• By David Kopf
• Jun 01, 2019

If you’ve been an HME professional for even just a few years, you know that success in this industry hinges on being able to roll with the punches and adapt to non-stop change.

Case in point: Round 2021 of competitive bidding. You likely already know that CMS has slated the next round of the national competitive bidding program for DMEPOS for 2021, but turning to the “News, Trends & Analysis” section starting on page 6, you’ll see that CMS and the Competitive Bidding Implementation Contractor (CBIC) have released the timeline for Round 2021. There are three key dates you should have committed to memory:

• June 10 is when registration begins.
• July 16 is when the bid window opens.
• Sept. 18 is when the bid window closes.

Be Prepared

Bearing those dates in mind, my question is this: Are you ready? Competitive bidding Round 2021 departs from previous rounds in several key ways. Here are three top-line changes:

• It uses lead item pricing, which means the single payment amount (SPA) for the lead item in each product category is based on the maximum or highest amount bid for the item by suppliers in the winning range. The SPAs for all other items in that category are then based on a percentage of that maximum winning lead item bid.
• Round 2021 now covers 16 product categories, including off-the-shelf (OTS) back braces, OTS knee braces, and non-invasive ventilators.
• Bidders must obtain a $50,000 bid surety bond from an authorized surety bond company.

Fortunately, there is a key resource you can tap into to learn more. If you haven’t yet, point your web browser at dmecbpeducation.com. The American Association for Homecare (AAHomecare), the Council for Quality Respiratory Care, and the VGM Group came together to create this site to better prepare for Round 2021, and the site delivers in that regard.

Not only does dmecbpeducation.com provide reams of information on Round 2021, but it also provides calculators offers a calculator at dmecbpeducation.com/bid-calculator that uses CBIC’s lead item ratios, but add features that include contextual information, such as rates currently in effect. This helps providers see how lead item bids compare to rates for non-lead items in both dollar amount and by percentage.

Be Involved

Just as we are going to press with this issue, AAHomecare reported that Reps. Cathy McMorris Rodgers (R-Wash.) and Dave Loebsack (D-Iowa) had introduced a House bill that would provide long-term rural and non-bid area relief as well as an oxygen reimbursement fix. It would:

• Permanently implement the 50/50 blended rural relief rate after 2020.
• Provide additional relief for non-rural, non-bid areas at the 75/25 blended rate.
• Cuts the oxygen budget neutrality requirement.

The legislation is perfectly timed as it is hitting just as providers are headed to Washington, D.C. for AAHomecare’s May 22-23 Washington Legislative Conference, but this will be an ongoing effort, and it will need your support, according to AAHomecare President and CEO Tom Ryan.

“This legislation will help suppliers outside of bidding areas serve patients and communities that, in many cases, have a limited healthcare infrastructure,” Ryan said in an AAHomecare statement. “It also provides a common-sense fix to outdated oxygen reimbursement policies that have driven rates for stationary oxygen in rural areas even lower than bidding program rates.”

So, my question is this: Are you involved? It’s time to hit aahomecare.org and vgmdclink.com. I’m sure that both sites will offer resources to help you contact your Representative and advocate for this legislation. Make sure that you do, because this is your chance to help solidify industry legislation gains, ensure proper funding, and protect your patients’ access to HME.

This article originally appeared in the June 2019 issue of HME Business.